1. Emergency Medicine PRIAPISM

2. The name priapism came from the Greek God Priapus (Ancient Greek), a fertility god often represented with a disproportionally larger & permanent erection.

3. Emergency medicine. (priaspism) Priapism is a painful condition in which erection does not return to its flaccid state within hours. Aspiration & irrigation with phenylephrine. One uses a butterfly needle with large pore (no. 19) on one side of corpora cavernosa & another needle on the opposite side for aspiration of the irrigated saline.

5. Causes
Priapism may veno-occlusive (ischemic), arteriasl (non ischemic) .
Causes:
1. Blood disorders; @ Sickle cell anemia @ Leukemia
2. Drugs for medication: @ Viagra, cialis, levbitra.
@ Papaverine @ Anti hypertensive most notably trazodone
@ Antidepressant e.g. flextime @ Antipsychotic disorders e.g chlorpromazine
@ Warfarin & heparin
Alcohol @ Cocaine , heroine or marjuana
4. Injury to genitalia or perineum.
5. Other factors: @ Spinal cord injury e.g. hanging victims (death erection)
@ Poisonous venoms e.g black widow spider bites.

6. Causes

11. Invasive treatment of priapism Van Der Horst, C
Invasive treatment of priapism Van Der Horst, C. et al International Braz.J. Urol. 29: October 2OO5.

12. Priaspism & penile gangrene due to thrombotic thrombocytopenic purpura

13. Malignant priapism due to primary carcinoma of the penis
Malignant priapism due to primary carcinoma of the penis. Bilatersal enlarged inguinal lymph nodes can be seen.

14. Malignant priapism secondary to osteogenic sarcomas Ischemic glans & penis after 4 weeks of priapism. Osteogenic sarcoma with tumor giant cells & atypical spindle cells. Koura, N. A. et al. Indian J. of cancer 48: 111, 2OO5